PURPOSE: This study investigated the mediating effects of loneliness and depression on the relationship between adult attachment and smartphone addiction in university students. METHODS: A total of 200 university students participated in this study. The data was analysed using descriptive statistics, correlation analysis, and structural equation modeling. RESULTS: There were significant positive relationships between attachment anxiety, loneliness, depression, and smartphone addiction. However, attachment anxiety was not significantly correlated with smartphone addiction. The results also showed that loneliness did not directly mediate between attachment anxiety and smartphone addiction. In addition, loneliness and depression serially mediated between attachment anxiety and smartphone addiction. CONCLUSION: The results suggest there are mediating effects of loneliness and depression in the relationship between attachment anxiety and smartphone addiction. The hypothesized model was found to be a suitable model for predicting smartphone addiction among university students. Future study is required to find a causal path to prevent smartphone addiction among university students.
Adult* ; Anxiety ; Depression* ; Family Relations ; Humans ; Loneliness* ; Negotiating* ; Smartphone*

BACKGROUND: Tumor associated macrophages (TAMs) and CXC chemokine receptor 4 (CXCR4) have emerged as potential biomarkers in various human cancers. The aims of this study were to investigate the clinical characteristics of anaplastic thyroid cancer (ATC) patients according to the TAM numbers in the tumor tissue, and to evaluate the associations between CXCR4 expressions and macrophage densities in ATC tumor microenvironment. METHODS: Total 14 ATC samples from thyroid tissue microarray were used. Immunohistochemical staining was performed using anti-CD163 and anti-CXCR4 antibodies. According to the immunoreactivity of CD163, all subjects were divided into two groups: low-CD163 (n=8) and high-CD163 (n=6) groups. RESULTS: The mean diagnostic age was 65±7 years and the median tumor size was 4.3 cm, ranging 2.5 to 15 cm. Clinicopathological characteristics were not significantly different between low-CD163 and high-CD163 groups, while age of diagnosis was younger in high-CD163 group than that of low-CD163 group with marginal significance (56.9±5.5 years vs. 67.5±6.8 years, P=0.09). However, overall survival was significantly reduced in high-CD163 group (5.5 months [range, 1 to 10]) compared with low-CD163 groups (8.8 months [range, 6 to 121); log-rank test, P=0.0443). Moreover, high-CD163 group showed strong CXCR4 expressions in both cancer and stromal compartments, while low-CD163 group showed relatively weak, stromal-dominant CXCR4 expressions. Additionally, CD163 and CXCR4 expressions showed a strong positive correlation (γ²=0.432, P=0.013). CONCLUSION: Increased number of TAMs showed poor overall survival in ATC, suggesting TAMs are potentially a prognostic biomarker for ATC. CXCR4 expression was significantly correlated with CD163-positive TAM densities, which suggest the possible role of CXCR4 in TAM recruitments.
Antibodies ; Biomarkers ; Diagnosis ; Humans ; Macrophages* ; Receptors, CXCR* ; Receptors, CXCR4* ; Thyroid Carcinoma, Anaplastic* ; Thyroid Gland ; Tumor Microenvironment

PURPOSE: In the gastric mucosa of Helicobacter pylori (H. pylori)-infected patients with gastritis or adenocarcinoma, proliferation of gastric epithelial cells is increased. Hyperproliferation is related to induction of oncogenes, such as β-catenin and c-myc. Even though transcription factors NF-κB and AP-1 are activated in H. pylori-infected cells, whether NF-κB or AP-1 regulates the expression of β-catenein or c-myc in H. pylori-infected cells has not been clarified. The present study was undertaken to investigate whether H. pylori-induced activation of NF-κB and AP-1 mediates the expression of oncogenes and hyperproliferation of gastric epithelial cells. MATERIALS AND METHODS: Gastric epithelial AGS cells were transiently transfected with mutant genes for IκBα (MAD3) and c-Jun (TAM67) or treated with a specific NF-κB inhibitor caffeic acid phenethyl ester (CAPE) or a selective AP-1 inhibitor SR-11302 to suppress activation of NF-κB or AP-1, respecively. As reference cells, the control vector pcDNA was transfected to the cells. Wild-type cells or transfected cells were cultured with or without H. pylori. RESULTS: H. pylori induced activation of NF-κB and AP-1, cell proliferation, and expression of oncogenes (β-catenein, c-myc) in AGS cells, which was inhibited by transfection of MAD3 and TAM67. Wild-type cells and the cells transfected with pcDNA showed similar activities of NF-κB and AP-1, proliferation, and oncogene expression regardless of treatment with H. pylori. Both CAPE and SR-11302 inhibited cell proliferation and expression of oncogenes in H. pylori-infected cells. CONCLUSION: H. pylori-induced activation of NF-κB and AP-1 regulates transcription of oncogenes and mediates hyperproliferation in gastric epithelial cells.
Blotting, Western ; Caffeic Acids ; Cell Line, Tumor ; Cell Proliferation ; DNA, Bacterial/analysis/genetics ; DNA-Binding Proteins/*metabolism ; Epithelial Cells/*metabolism ; Gastric Mucosa/*metabolism/pathology ; Gastritis/pathology ; Gene Expression Regulation, Bacterial ; Helicobacter Infections/metabolism/pathology/physiopathology ; Helicobacter pylori/pathogenicity/physiology ; Humans ; NF-kappa B/antagonists & inhibitors/*biosynthesis/metabolism ; Peptide Fragments ; Phenylethyl Alcohol/analogs & derivatives ; Proto-Oncogene Proteins c-jun ; Repressor Proteins ; Transcription Factor AP-1/*biosynthesis ; Transcription Factors/*metabolism ; beta Catenin/*metabolism

BACKGROUND: Since cell turnover in the hematopoietic system constitutes a major source of uric acid (UA) production, we investigated whether hematopoietic stem cell transplantation (HSCT) is associated with significant changes in serum UA levels in patients with hematological disorders. METHODS: Patients who underwent HSCT at our institution between 2001 and 2012 were retrospectively enrolled. Serum UA levels at 3 months before, 1 week before, and 3 months and 1 year after HSCT were examined. RESULTS: Complete clinical and laboratory information including data regarding UA levels was available for 93 patients. At baseline, the mean UA level was 4.9±2.1 mg/dL, with an overall prevalence of hyperuricemia of 15% (defined as serum UA>6.8 mg/dL). Mean UA levels tended to be higher in patients with acute myeloid leukemia (4.8±2.0 mg/dL) and non-Hodgkin lymphoma (5.1±2.3 mg/dL) and lower in patients with aplastic anemia (mean, 4.2±1.8 mg/dL). UA levels dropped during myeloablative conditioning, reaching a nadir on the day of HSCT (3.27±1.4 mg/dL). Over the 3 months following HSCT, UA levels rose sharply (5.0±2.1 mg/dL) and remained stable up to 1 year after HSCT (5.5±1.6 mg/dL). UA levels in HSCT recipients at 12 months correlated with those of their respective graft donors (Pearson r=0.406, P=0.001). CONCLUSION: HSCT is associated with significant changes in uric acid levels in patients with hematologic disorders.
Anemia, Aplastic ; Bone Marrow ; Cohort Studies* ; Hematopoietic Stem Cell Transplantation ; Hematopoietic System ; Humans ; Hyperuricemia ; Leukemia, Myeloid, Acute ; Lymphoma, Non-Hodgkin ; Prevalence ; Retrospective Studies* ; Stem Cell Transplantation* ; Stem Cells* ; Tissue Donors ; Transplants ; Uric Acid*

BACKGROUND: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. METHODS: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. RESULTS: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. CONCLUSIONS: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.
Anxiety ; Depression ; Diagnosis ; Epilepsy* ; Humans ; Hypochondriasis ; Hysteria ; MMPI* ; Neurons ; Paranoid Disorders ; Schizophrenia ; Seizures*

Purpose: The purpose of this study was to analyze articles published in the Journal of the Korean Academy of Nursing (JKAN) between 2010 and 2019, along with those published in three international nursing journals, to improve JKAN’s international reputation. Methods: The overall characteristics of JKAN’s published papers and keywords, study participants, types of nursing interventions and dependent variables, citations, and cited journals were analyzed. Additionally, the keywords and study designs, publication-related characteristics, journal impact factors (JIF), and Eigenfactor scores of International Journal of Nursing Studies (IJNS), International Nursing Review (INR), Nursing & Health Sciences (NHS), and JKAN were analyzed and compared. Results: Among the four journals, JKAN’s score was the lowest in both the journal impact factor and Eigenfactor score. In particular, while the JIF of INR and NHS has been continuously increasing; JKAN’s JIF has remained static for almost 10 years. The journals which had cited JKAN and those which JKAN had cited were mainly published in Korean. Conclusion JKAN still has a low IF and a low ranking among Social Citation Index (E) journals during the past 10 years, as compared to that of four international journals. To enhance JKAN’s status as an international journal, it is necessary to consider publishing it in English and to continuously improve the conditions of other publications.

Purpose: This year 2020 marks the 50th anniversary of the founding of the Korean Society of Nursing Science (KSNS). This study wasaimed to explore development of caring and describe the 50 years of history of KSNS within the sociocultural context of Korea regardingacademic footsteps, meanings, and implications for the future. Methods: This study used a historical research methodology using a literaturereview and bibliometric analysis. Relevant literature was reviewed and the published abstracts in the Journal of Korean Academy ofNursing (JKAN) were analyzed using VOSviewer. Results: Birth control and family planning in the 1970s was the main research topic. In the1980s, the development of nursing concepts, theories, and philosophies was the mission of KSNS to extend the disciplinary boundary. In the1990s, the progress of KSNS to become one of the woman-dominant healthcare professionals was the mission in the given period. Expandingthe frontiers of KSNS to the extent of global standards was the undertaking of the nursing scholars in the 2000s. Lastly, in the 2010s,the quality and quantity improvement of KSNS and JKAN is expected to make our future even prosperous. The map visualization of the 50years of research accumulation showed the comparable opposition of quantitative vs. qualitative research methodologies, equation modeling,and instrument development. Conclusion These clusters of research demonstrates the efforts to make nursing evidence by Koreannursing scholars for the last five decades. The growth in the slope of KSNS and outcomes of JKAN are to carry on to an unimaginable extentin the future.

Purpose: We used next-generation sequencing (NGS) to investigate the genetic causes of suspected genetic short stature in 37 patients, and we describe their phenotypes and various genetic spectra. Methods: We reviewed the medical records of 50 patients who underwent genetic testing using NGS for suspected genetic short stature from June 2019 to December 2022. Patients with short stature caused by nongenetic factors or common chromosomal abnormalities were excluded. Thirty-seven patients from 35 families were enrolled in this study. We administered one of three genetic tests (2 targeted panel tests or whole exome sequencing) to patients according to their phenotypes. Results: Clinical and molecular diagnoses were confirmed in 15 of the 37 patients, for an overall diagnostic yield of 40.5%. Fifteen pathogenic/likely pathogenic variants were identified in 13 genes (ACAN, ANKRD11, ARID1B, CEP152, COL10A1, COL1A2, EXT1, FGFR3, NIPBL, NRAS, PTPN11, SHOX, SLC16A2). The diagnostic rate was highest in patients who were small for their gestational age (7 of 11, 63.6%). Conclusion Genetic evaluation using NGS can be helpful in patients with suspected genetic short stature who have clinical and genetic heterogeneity. Further studies are needed to develop patient selection algorithms and panels containing growth-related genes.

Multiple myeloma (MM) is a malignant disease caused by an abnormal proliferation of plasma cells, of which the prognostic factors include chromosomal abnormality, β-2 microglobulin, and albumin. Recently, the term chromothripsis has emerged, which is the massive but highly localized chromosomal rearrangement in response to a one-step catastrophic event. Many studies have shown an association of chromothripsis with the prognosis in several cancers; however, few studies have investigated it in MM. Here, we studied the association between chromothripsis-like patterns and treatment resistance or prognosis. First, we analyzed nine MM cell lines (U266, MM.1S, RPMI8226, KMS-11, KMS-12-BM, KMS-12-PE, KMS-28-BM, KMS-28-PE, and NCI-H929) and bone marrow samples of four patients who were diagnosed with MM by next-generation sequencing-based copy number variation analysis. The frequency of the chromothripsis-like pattern was observed in seven cell lines. We analyzed the treatment-induced chromothripsis-like patterns in KMS-12-BM and KMS-12-PE cells. As a result, breakpoints and chromothripsis-like patterns were increased after drug treatment in the relatively resistant KMS-12-BM. We further analyzed the patients’ results according to the therapeutic response, which was divided into sensitive and resistant, as suggested by the International Myeloma Working Group. The chromothripsis-like pattern was more frequently observed in the resistant group. In the sensitive group, the frequency of the chromothripsis-like pattern decreased after treatment, whereas the resistant group showed increased chromothripsis-like patterns after the treatment. These results suggest that the chromothripsis-like pattern is associated with treatment response in MM.
Bone Marrow ; Cell Line ; Chromosome Aberrations ; Drug Resistance ; Humans ; Multiple Myeloma* ; Plasma Cells ; Prognosis

BACKGROUND: Leg edema is a common symptom among elderly patients with multiple underlying diseases. This study was aimed to investigate the etiologies and underlying diseases of leg edema in elderly patients. METHODS: We retrospectively reviewed medical records of 247 patients aged over 65, who visited an Emergency Department of a tertiary hospital due to leg edema from January 2010 to December 2012. RESULTS: A total of 226 patients with complete medical records were included. The most common cause of leg edema in elderly patients was renal failure (42 cases, 18.6%), followed by heart failure (37 cases, 16.4%), and deep vein thrombosis (32 cases, 14.2%). However, the etiologies were not established in 66 cases (29.2%). Patients with leg edema caused by renal and heart failure had renal (40 cases, 95.2%) and cardiovascular diseases (29 cases, 78.4%), respectively, while others had diabetes mellitus and trauma. Patients with leg edema caused by deep vein thrombosis had underlying conditions such as cancer (13 cases, 40.6%), trauma, surgery within 1 year, and diabetes mellitus. Overall, chronic bilateral edema (120 cases, 53.1%) was most commonly observed form of leg edema in elderly patients. Deep vein thrombosis, cellulitis, and lymphedema usually caused unilateral edema, whereas systemic diseases such as renal failure, heart failure, and liver cirrhosis caused bilateral edema. CONCLUSION: Leg edema in elderly patients is usually caused by systemic diseases such as renal and heart failure closely related to underlying diseases. Therefore, it is important to consider the variety of underlying diseases, when approaching the cause and treatment of leg edema in elderly patients.
Aged* ; Cardiovascular Diseases ; Cellulitis ; Diabetes Mellitus ; Edema* ; Emergency Service, Hospital ; Heart Failure ; Humans ; Leg* ; Liver Cirrhosis ; Lymphedema ; Medical Records ; Renal Insufficiency ; Retrospective Studies ; Tertiary Care Centers ; Venous Thrombosis